Zhou Yuankai, He Huaiwu, Cui Na, Wang Xiaoting, Long Yun, Liu Dawei
Department of Critical Care Medicine, State Key Laboratory of Complex Severe and Rare Diseases, Peking Union Medical College Hospital, Peking Union Medical College, Chinese Academy of Medical Sciences, Beijing, China.
Front Surg. 2023 Jan 6;9:1049753. doi: 10.3389/fsurg.2022.1049753. eCollection 2022.
This study examined whether alterations in Doppler parameters of superior mesenteric artery (SMA) are associated with prolonged mechanical ventilation (PMV) in patients who underwent cardiac valve surgery.
Hemodynamic and SMA Doppler parameters were collected at intensive care unit(ICU) admission. The duration of mechanical ventilation was monitored. PMV was defined as mechanical ventilation ≥96 h.
A total of 132 patients admitted to ICU after cardiac valve surgery were evaluated for enrollment, of whom 105 were included. Patients were assigned to the control ( = 63) and PMV ( = 42) groups according to the mechanical ventilation duration. The pulsatility index(SMA-PI) and resistive index of SMA (SMA-RI) were 3.97 ± 0.77 and 0.88 (0.84-0.90) in the PMV group after cardiac valve surgery, which was lower than the SMA-PI (2.95 ± 0.71, < 0.0001) and SMA-RI of controls (0.8, 0.77-0.88, < 0.0001). SMA-PI at admission had favorable prognostic significance for PMV (AUC = 0.837, < 0.0001).
An elevated SMA-PI is common in patients after cardiac valve surgery with PMV. Increased SMA-PI could help predict PMV after cardiac valve surgery. Using point-of-care ultrasound to measure SMA-PI at ICU admission is an acceptable and reproducible method for identifying patients with PMV.
本研究旨在探讨接受心脏瓣膜手术患者的肠系膜上动脉（SMA）多普勒参数改变是否与机械通气时间延长（PMV）相关。
在重症监护病房（ICU）入院时收集血流动力学和SMA多普勒参数。监测机械通气时间。PMV定义为机械通气≥96小时。
共有132例心脏瓣膜手术后入住ICU的患者接受入组评估，其中105例被纳入研究。根据机械通气时间将患者分为对照组（n = 63）和PMV组（n = 42）。心脏瓣膜手术后PMV组的搏动指数（SMA-PI）和SMA阻力指数（SMA-RI）分别为3.97±0.77和0.88（0.84 - 0.90），低于对照组的SMA-PI（2.95±0.71，P < 0.0001）和SMA-RI（0.8，0.77 - 0.88，P < 0.0001）。入院时的SMA-PI对PMV具有良好的预后意义（AUC = 0.837，P < 0.0001）。
心脏瓣膜手术后发生PMV的患者中SMA-PI升高较为常见。升高的SMA-PI有助于预测心脏瓣膜手术后的PMV。在ICU入院时使用床旁超声测量SMA-PI是识别PMV患者的一种可接受且可重复的方法。
